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LDMH: A Handbook on

Learning Disabilities And Mental Health

Designed by Integra Program staff As part of our Community Education & Engagement (CEE) Program

The Integra Program by Child Development Institute is funded by

Ontarios Ministry of Children and Youth Services

Table of Contents

Foreword ....................................................................................................................... 2

Introduction to the Handbook on Learning Disabilities and Mental Health ................... 3

Introduction to Learning Disabilities .............................................................................. 4

What are Learning Disabilities (LDs)?.......................................................................... 4

How are LDs Identified? .............................................................................................. 5

How Common are LDs? .............................................................................................. 5

What Causes LDs? ...................................................................................................... 5

What is the difference between Learning Disabilities and Learning Disorders? .......... 5

The Relationship between Learning Disabilities and Mental Health (LDMH) ................. 6

What is Mental Health? .............................................................................................. 6

The Continuum of Mental Health ............................................................................... 6

What is the Relationship between Learning Disabilities and Mental Health? ............. 6

Experiential Avoidance ............................................................................................... 7

Fight, Flight and Freeze ............................................................................................... 8

LDs Complicate Mental Illness .................................................................................... 8

LDs and Emotion Regulation ....................................................................................... 9

The Impact of LDs on Social Relationships ................................................................ 10

LDMH: A Framework for Understanding Challenging Behaviours ............................. 11

LDs Reflecting challenges with Executive Functioning ................................................. 13

LDs Reflecting challenges with Phonological Processing .............................................. 17

LDs Reflecting challenges with Language Processing ................................................... 20

LDs Reflecting challenges with Memory....................................................................... 22

LDs Reflecting challenges with Visual-Spatial and Visual-Motor Processing ................. 25

LDs reflecting challenges with Processing Speed ......................................................... 28

Conclusion ................................................................................................................... 30

Helpful Resources ........................................................................................................ 31

Integra Handbook on LDMH References ...................................................................... 35

Integra Program Handbook on LDMH

2

Copyright 2016

Foreword

In October 2014, Integra Foundation amalgamated with Child Development Institute (CDI), bringing together two like-minded, accredited childrens mental health organizations, and strengthening Integras therapeutic services for children and youth with learning disabilities and mental health issues (LDMH). The Integra Program of CDI is the only accredited childrens mental health agency in Canada to provide mental health services exclusively to children and youth whose mental health issues (MH) are complicated by learning disabilities (LDs). We provide family-centred, evidence-informed direct clinical services to children and youth with diagnosed LDs ages 8 to 18 years in the Toronto region. Eligible to Ontario residents, Integra also operates Towhee, a three-week residential summer program for children and youth with LDs, located in Halliburton, Ontario. We provide community education and training on topics pertaining to LDMH to audiences in the province and beyond. The Community Education and Engagement (CEE) Program at Integra was developed to promote a community-wide understanding of the mental health needs of children and adolescents who have learning disabilities. Through public education, workshops, staff training series and consultation, the program disseminates current information about learning disabilities and evidence-informed, best practice in related mental health fields. Our aim is to dispel myths and improve societal attitudes toward individuals with learning disabilities and mental health issues (LDMH). It is our position that widespread understanding of LDMH will contribute to healthier communities for children and families. We work collaboratively with organizations to tailor our education to the particular audience. This handbook is designed to complement participation in our CEE workshops and training programs. The Integra Handbook on Learning Disabilities was first developed in 2007 by Dr. Barb Muskat to complement our flagship workshop Walk a Mile in My Shoes, which we adapted with permission from workshop ideas of Dr. Richard Lavoie. This handbook was revised in 2009 by Dr. Marjory Phillips, Melissa Rowbotham, and Helen Hargreaves. This third revision, reflecting our focus on Learning Disabilities and Mental Health issues (LDMH) was drafted by Dr. Jen Scully, Kate Cressman, and Dr. Marjory Phillips in 2016. Our flagship workshop is the Integra Walk-A-Mile in My Shoes workshop, originally developed by Dr. Barb Muskat, and updated and revised by Integra staff including Melissa Rowbotham, Dr. Marjory Phillips, Helen Hargreaves, Kate Cressman, and Dr. Jen Scully. The workshop provides participants with an opportunity to experience the emotional impact of having learning disabilities while also gaining an understanding of the nature of the challenges. Research on the efficacy of the Walk a Mile workshop suggests that participants gain empathy as a catalyst for implementing practical changes and accommodations (Milligan et al., 2010). We welcome any questions or comments. For more information about the CEE program, including a list of upcoming workshops or to book a workshop or training series for your school or agency, please contact the Integra Program (416-603-1827, press 3) or visit our website at www.childdevelop.ca/programs/integra-program/workshops-and-training.

http://www.childdevelop.ca/programs/integra-program/workshops-and-training

Integra Program Handbook on LDMH

3

Copyright 2016

Introduction to the Handbook on Learning Disabilities and Mental Health

The relationship between Learning Disabilities and Mental Health is complex. Persons with Learning Disabilities (LDs) have unique patterns of processing information and individual learning styles. Moreover, these learning styles change with development, and the impact of Learning Disabilities varies as a child grows and develops. It can be hard to show what you know when you have LDs, and sometimes it can be hard to make sense of certain things, such as social interactions. In response to the challenges of having LDs, children and youth often experience social and emotional stresses, including feelings of frustration, worry, or loneliness. At the Integra Program, we also see children and youth with LDs who experience significant difficulties with anxiety or depression, or with managing strong emotions. It is our view that in order to support children and youth with Learning Disabilities AND mental health issues (LDMH), we need to understand how the learning profile fits in with the child or youths mental health. For example, difficulties in concentration may reflect specific learning issues (such as understanding language, remembering what one hears, or attention), or mental health issues (such as worry, anxiety, or sadness), and most often, a combination of both factors. Our hope for this Handbook is to provide information about Learning Disabilities and Mental Health to illustrate how these two complex presentations may intersect. Being able to understand strengths, challenges and behaviours from the dual lenses of LD and MH provides adults who work with these children and youth with a greater repertoire of strategies and tools to support good mental health and wellbeing. The LDMH Handbook is structured to provide a useful reference guide. In the first section, we provide general information about the definition of Learning Disabilities and about the relationship between LD and Mental Health. In the second and largest section, we deconstruct each type of cognitive or psychological process, to explain terms and what challenges with that cognitive process might look like. Although each child or youth is unique, we provide a case example for each cognitive process to illustrate one way in which Learning Disabilities may intersect with Mental Health issues. In the appendix, we provide links and references to useful websites or more information. Our goal is to provide the reader with more ideas to answer the questions, what might this behaviour be? and how can I support this child or youth to develop strengths and wellbeing? We encourage readers to contact the Community Education & Engagement department of the Integra Program, Child Development Ins

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